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Oral cryotherapy for oral mucositis management in patients receiving allogeneic hematopoietic stem cell transplantation: a prospective randomized study

  • Yin Lu
  • Xiaming Zhu
  • Qin Ma
  • Juan Wang
  • Pingfang Jiang
  • Shizhen Teng
  • Lili Zhou
  • Depei Wu
  • Haifang WangEmail author
Original Article
  • 11 Downloads

Abstract

Purpose

To explore the best schedule of oral cryotherapy for the prevention of oral mucositis in recipients of myeloablative hematopoietic stem cell transplantation (HSCT).

Methods

A prospective randomized study was conducted to recruit allogeneic HSCT recipients, who were then randomly allocated into four arms to accept the following: oral cryotherapy during the whole course (arm A) or second half of the course (arm B) of cytotoxic agents administration, regular oral cryotherapy twice a day (arm C), or conventional oral care without cryotherapy (arm D). Status of oral mucositis was daily assessed from the first day of conditioning to the 15th day post-HSCT. A myeloablative conditioning regimen was used which was composed of busulfan, cyclophosphamide, and cytarabine.

Results

Totally 160 cases were consecutively enrolled in this study, and 145 cases were eligible for oral mucositis assessment. Both arm A and arm B were associated with a lower incidence and short duration of severe mucositis (≥ grade 3), although no statistical difference was found between these two groups (p = 0.463, p = 0.678). The highest incidence of severe mucositis was observed in arm C. Recovery of mucositis also had a significant diversity among the 4 arms (F = 4.133, p = 0.008).

Conclusions

Risk and outcome of severe oral mucositis could be ameliorated by oral cryotherapy during the administration of cytotoxic agents for allogeneic HSCT patients receiving non-radiation myeloablative conditioning regimen, and a half-course schedule could acquire a comparable efficacy compared with the whole-course schedule.

Keywords

Cryotherapy Oral mucositis Allogeneic hematopoietic stem cell transplantation 

Notes

Acknowledgments

We sincerely acknowledge Dr. Jing Yang for her assistance with the statistical consultant in this study. We also express our gratitude to the clinical staff in the Stem Cell Transplantation Unit of the First Affiliated Hospital of Suzhou University.

Funding

This study was supported by a grant from Suzhou People’s Livelihood Science and Technology project (SYSD2016083).

Compliance with ethical standards

All participants provided informed consent, and the study was approved by the ethical institution of the First Affiliated Hospital of Soochow University (no. 2017021).

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yin Lu
    • 1
    • 2
    • 3
    • 4
  • Xiaming Zhu
    • 1
    • 2
    • 3
    • 4
  • Qin Ma
    • 1
    • 2
    • 3
    • 4
  • Juan Wang
    • 1
    • 2
    • 3
    • 4
  • Pingfang Jiang
    • 1
    • 2
    • 3
    • 4
  • Shizhen Teng
    • 1
    • 2
    • 3
    • 4
  • Lili Zhou
    • 1
    • 2
    • 3
    • 4
  • Depei Wu
    • 1
    • 2
    • 3
    • 4
  • Haifang Wang
    • 5
    Email author
  1. 1.Department of HematologyThe First Affiliated Hospital of Soochow UniversitySuzhouPeople’s Republic of China
  2. 2.Hematopoietic Transplant InstituteSoochow UniversitySuzhouPeople’s Republic of China
  3. 3.Jiangsu Institute of HematologyThe First Affiliated Hospital of Soochow UniversitySuzhouPeople’s Republic of China
  4. 4.Collaborative Innovation Center of HematologySoochow UniversitySuzhouPeople’s Republic of China
  5. 5.Department of NursingThe First Affiliated Hospital of Soochow UniversitySuzhouPeople’s Republic of China

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